Annotated Bib, post 7

Yano, Elizabeth M., Steven M. Asch, Barbara Phillips, Henry Anaya, Candice Bowman, Sophia Chang, and Samuel Bozzette. “Organization and Management of Care for Military Veterans with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome in Department of Veterans Affairs Medical Centers.” Military Medicine 170, no. 11 (November 2005): 952–59.
The Department of Veterans Affairs (VA), being the largest provider for HIV health care services, has launched a national quality improvement program. The source aims to assess the care for HIV infected veterans was conducted. Surveys in 118 VA facilities with senior HIV clinicians were given discussing staffing, approaches, and delivery of HIV health services. Selection was made by a census of all VA medical centers (VAMC) that cared for one or more HIV-infected patients during the 1999 fiscal year. Senior clinicians were asked to participate as the informants for the surveys, which had adapted measures of multiple aspects to HIV care.
Of 165 VAMCs that reported serving one or more HIV patients, 27 informed the surveyors that they redirect their patients to a larger VAMC. Of the remaining 138, 118 responded. Most patients received care through a specialty clinic, with a smaller portion getting care from a primary care provider and HIV expert. Most VAMCs managed HIV patients with some joint care involving an expert, but only one VAMC reported their facility had a dedicated HIV/AIDS inpatient ward.
Staffing could range from 1 to 50 in HIV providing for each facility. Notably, providers generally had greater than 10 years of experience in treating HIV patients. 53% of the facilities reported having HIV experts available 24 hours a week.
Only a few VAMCs wrote any HIV-related directives, policies, or programs for treatment adherence. Commonly, programs were inventions to influence patient behavior (38%), followed by courses for HIV providers (23%). 17% of facilities had reminder systems that prompted clinicians to ask about their patients’ adherence. Only 47% of VAMCs adopted HIV practice guidelines.
The source states that the costs and processes to treat HIV in the medical field will continuously accelerate. Consequently, understanding the environment and its organization in the health care services is important to improve quality and must be done routinely.
Final Thoughts
This source discusses multiple VAMCs and how well equipped they are for HIV-related patients. This source, written in Military Medicine in 2005, may be a little outdated, but gave statistics relevant to its time and is a good starting point for future/current VAMCs clinicians to compare for improvement. Being where this article was published, there might be some reason to believe that the studies were biased, but the statistics seem honest enough to demonstrate otherwise. I chose this source because I was curious about how the VA was dealing with HIV/AIDS in more current times because other sources mentioned the lack of care for LGBT service members.

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